Neonatal Intensive Care Unit (NICU) nurses need useful diagnostic tools to decide when a tube-fed, premature infant is ready to feed orally. The problem of identifying feeding readiness in this population is important not only from a utilization standpoint, because tube-feeding deprives pre-term infants of sensory experiences that would improve their developmental skills, and speed their progress to independent oral feeding. For example, newborns are instinctively attracted to breast milk odor, and they show sucking behavior in response to the scent of their mothers' breast milk. However, tube-fed pre-term infants have limited experience of breast milk odor. An ultimate goal of this proposal is to restore the disrupted chemosensory bond between mother and pre-term newborn, in order to promote oral motor development and successful breastfeeding. Since clinical trials by NICU nurses and others have shown that the encouragement of non-nutritive sucking (sucking without swallowing) promotes oral feeding by tube-fed, pre- term infants, this proposal initially focuses on the relationship between non-nutritive sucking by individual tube fed infants and feeding competence. Our preliminary evidence indicates that breast milk odor, reinforces non-nutritive sucking. We seek to confirm and extend these findings concerning the effect of nutrient odor on non-nutritive sucking by using an olfactometer, permitting rigorous assessment of behavioral effects. Finally, proposed studies culminate in a clinical trial of the effect of a novel developmental care intervention for tube-fed, premature infants- exposure to breast milk odor- on early oral feeding milestones in these patients. With increasing recognition that premature newborns have long-term developmental impairment, research on developmental interventions that can improve short-term developmental markers becomes ever more pressing. This research aims to improve the outcome of premature birth by strengthening infants' feeding skills. In the long run, adapting newborns' well-known attraction to breast milk odor to clinical care in the NICU will not only improve nutritional status and oral motor skills of tube-fed infants, but also their social bond with mothers. The approaches outlined here will contribute to successful feeding by newborns with other illnesses. [unreadable] [unreadable]